Coronavirus Survive & Thrive Guide for Caregiver ...€¦ · Survive & Thrive Guide: Keeping Your...

1

Emerging Threats

Community of Practice

Med Tac Bystander Rescue Care

Bystander Rescue Care

CareUniversity Series

May 21, 2020 CareUniversity Webinar #139

For resource downloads go to:

www.MedTacGlobal.org

Coronavirus Survive & Thrive Guide

for Caregiver & Critical Worker Families

2

Emerging Threats





Charles Denham, MD Chairman, TMIT Global

Founder Med Tac Bystander Rescue Care

Med Tac Bystander Rescue Care March 21, 2020 CareUniversity Webinar #139

Welcome

3

Emerging Threats





To optimize webinar sound volume, please check:

• WebEx volume

• Computer volume

• External speaker volume

4

Emerging Threats





If you are still having difficulty hearing the webinar:

Please click on Participants

Then the “Request Phone” button to receive a toll dial-in

5

Emerging Threats





Our Purpose Statement

Our Purpose:

We will measure our success by how we protect and enrich the lives of families…patients AND caregivers.

Our Mission:

To accelerate performance solutions that save lives, save money, and create value in the communities we serve and ventures we undertake.

CAREUNIVERSITY ®

EMERGING THREATS

COMMUNITY OF PRACTICE

6

Emerging Threats





Speakers

& Reactors

Dr. Charles Denham

Chief William Adcox Dr. Gregory Botz

Becky Martins

Heather Foster RN

Dr. Christopher Peabody

7

7

www.MedTacGlobal.org


for Failure to Rescue

10

Emerging Threats





Disclosure Statement The following panelists certify that unless otherwise noted below, each presenter provided full disclosure information; does not intend to

discuss an unapproved/investigative use of a commercial product/device; and has no significant financial relationship(s) to disclose. If

unapproved uses of products are discussed, presenters are expected to disclose this to participants. None of the participants have any

relationship medication or device companies discussed in their presentations.

• Gregory H. Botz, MD, FCCM, is a professor in the Department of Critical Care at the UT MD Anderson Cancer Center. He received his medical degree from George

Washington University School of Medicine in Washington, DC. He completed an internship in internal medicine at Huntington Memorial Hospital and then completed

a residency in anesthesiology and a fellowship in critical care medicine at Stanford University in California. He also completed a medical simulation fellowship at

Stanford with Dr. David Gaba and the Laboratory for Human Performance in Healthcare. Dr. Botz is board-certified in anesthesiology and critical care medicine. He

is a Fellow of the American College of Critical Care Medicine. He has nothing to disclose.

• William H. Adcox serves as the Chief of Police and CSO at The University of Texas MD Anderson Cancer Center and The University of Texas Health Science Center.

He has nothing to disclose.

• Becky Martins has nothing to disclose.

• Heather Foster has nothing to disclose.

• Charles Denham, MD, is the Chairman of TMIT; a former TMIT education grantee of CareFusion and AORN with co-production by Discovery Channel for Chasing

Zero documentary and Toolbox including models; and an education grantee of GE with co-production by Discovery Channel for Surfing the Healthcare Tsunami

documentary and Toolbox, including models. HCC is a former contractor for GE and CareFusion, and a former contractor with Siemens and Nanosonics, which

produces a sterilization device, Trophon. HCC is a former contractor with Senior Care Centers. HCC is a former contractor for ByoPlanet, a producer of sanitation

devices for multiple industries. He does not currently work with any pharmaceutical or device company. His current area of research is in threat management to

institutions including conflict of interest, healthcare fraud, and continuing professional education and consumer education including bystander care. Dr. Denham is

a collaborator with Professor Christensen at Harvard Business School.

11

Emerging Threats





Becky Martins

Founder, Voice4Patients.com

TMIT Patient Advocate Team

Member

Warren, ME

Voice of the Patient

© 2006 HCC, Inc. CD000000-0000XX 12 Med Tac Bystander Rescue Care

Meaningful Use is dead. Long live something better! The 4 P’s to Address Emerging Threats

CAREUNIVERSITY ®

EMERGING THREATS

COMMUNITY OF PRACTICE

Global Patient

Safety Forum

SAFETYLEADERS ®


Cardiac Arrest

Meaningful Use is dead. Long live something better! High Impact Care Hazards to Patients, Students, and Employees

Opioid Overdose

Common Accidents

Bullying

A Medical-Tactical Approach undertaken by

clinical and non-clinical people can have

enormous impact on los of life and harm

from very common hazards:

• High Impact Care Hazards are frequent,

severe, preventable, and measurable.

• Lifeline Behaviors undertaken by anyone

can save lives.

Choking & Drowning

Anaphylaxis

Major Trauma

Transportation Accidents

Med Tac

Story Article

Active Shooter

Healthcare Article

AED & Bleeding

Control Gear Article

Rapid Response

Teams Article

Battling Failure to Rescue

Automated External

Defibrillator

& Bleeding Control

Gear Placement

14 © 2020 TMIT

Meaningful Use is dead. Long live something better! In the News: Med Tac Updates

Source: Campus Safety Nov/Dec Issue - https://www.campussafetymagazine.com/public/med-tac-training-bystanders/

Nov/Dec 2018 Issue

Emerging Threats




15 © 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity

Ann Rhoades

Dr. Charles Denham Chief William Adcox Dr. Gregory Botz

Randy Styner Dr. Chris Fox Tom Renner David Beshk

Dennis Quaid John Nance JD Beth Ullem

John Little

Dr. Casey Clements

Dr. Steve Swensen Perry Bechtle III Fred Haise

Nancy Conrad

Dr. Mary Foley

Heather Foster

Dr. Chopra

Betsy Denham Becky Martins

Debbie Medina

Preston Head III

Charlie Denham III

Dr. McDowell

Tyler Sant Avarie Pettit Bob Chapman

Dr. C Peabody

Emerging Threats




16 © 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity

Dan Ford

C Sullenberger Charlotte Guglielmi

Bill George Penny George

Dr. Don Berwick

Contributions Through Segments of Documentaries

Dr. Howard Koh Jim Collins Dr. Jim Bagian

Arlene Salamendra Jennifer Dingman

Dr. Harvey Fineberg

Hilary Schmidt PhD

Prof Christensen

Paul Bhatia EMT

17

Emerging Threats





Heather Foster RN Dr. Gregory H. Botz William Adcox, MBA



Meaningful Use is dead. Long live something better! Essential Critical Infrastructure Workers


Meaningful Use is dead. Long live something better! Essential Critical Infrastructure Workers

40% of

Work

Force

No Family

Training

Provided

© 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity

Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Protecting Your Family

Survive & Thrive Guide: Preparing for Care at Home



Survive & Thrive Guides

22

Emerging Threats





Heather Foster RN Dr. Gregory H. Botz William Adcox, MBA



Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Keeping Your Family Safe

Understand

the Basics

The Basics

Form Family Team &

Health Security Plan

Care of Your

Loved Ones

Leadership Practices

• Why Checklists?

• Setting up Care Room

• Protecting Caregivers

• Protecting the Family

• Family Health Security Plan

• The Family CFO

• Engaging Family: Head,

Heart, Hands, & Voice

• Critical Concepts

• Prevention, Preparedness,

Protection, & Performance

Improvement – The 4 P’s

• How the Virus Spreads

Putting Supplies

& Gear to Work

Technologies

• Supplies & Gear

Checklist

• Seniors & At-Risk Care

Checklists to be Safe

• Innovating Solutions

Preparing for Care at Home



Understand

the Basics

The Basics

Form Family Team &


Care of Your

Loved Ones


Putting Supplies

& Gear to Work

Technologies



• Prevention, Preparedness,

Protection, & Performance

Improvement – The 4 P’s




Understand

the Basics

The Basics

Care of Your

Loved Ones


Putting Supplies

& Gear to Work

Technologies



• The Family CFO

• Engaging Family: Head, Heart,

Hands, & Voice

Form Family Team &




Understand

the Basics

The Basics

Care of Your

Loved Ones


Putting Supplies

& Gear to Work

Technologies


Form Family Team &


• Why Checklists?






Understand

the Basics

The Basics

Care of Your

Loved Ones


Putting Supplies

& Gear to Work

Technologies


Form Family Team &


Putting Supplies

& Gear to Work

• Supplies & Gear Checklist

• Seniors & At-Risk Care Checklists to

be Safe




Understand

the Basics

The Basics

Understand

the Basics

The Basics

29

Emerging Threats





For resource downloads go to: www.MedTacGlobal.org

Gregory H. Botz, MD, FCCM

Professor of Anesthesiology and

Critical Care

UT – MD Anderson Cancer Center

Adjunct Clinical Associate Professor,

Department Anesthesiology

Stanford University Medical School




Sources of Infections

Days Since Infection

Presymptomatic 45%

Symptomatic 40%

Environment 10%

Asymptomatic 5%

New Infections Caused by Day

0.3

0.2

0.1

0 0 2.5 5.0 7.5 10.0 12.5

Source: Chart Graphically adapted by Charles Denham from Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing Ferretti et al., Science 368, 619 (2020) 8 May 2020 and Tomas Pueyo adaptation

Presymptomatic Patient Transmission before infected

patients experience symptoms

45%





Presymptomatic 45%

Symptomatic 40%

Asymptomatic 5%


0.3

0.2

0.1

0 0 2.5 5.0 7.5 10.0 12.5


Symptomatic Patient Transmission from infected

patients experiencing symptoms

40%

Environment 10%





Presymptomatic 45%

Symptomatic 40%

Asymptomatic 5%


0.3

0.2

0.1

0 0 2.5 5.0 7.5 10.0 12.5


Environmental Sources are likely from Contact Surfaces

10%

Environment 10%





Presymptomatic 45%

Symptomatic 40%

Asymptomatic 5%


0.3

0.2

0.1

0 0 2.5 5.0 7.5 10.0 12.5


Asymptomatic Patients who are infected and never

get symptoms 5% Environment 10%


Meaningful Use is dead. Long live something better! Keeping You and Your Family Safe

Understand

the Basics

The Basics


• The 4 P’s: Prevention,

Preparedness,

Protection, &

Performance

Improvement



SOURCE: CDC Website

Social

Distancing

Hand

Washing

Disinfecting

Surfaces

Care at

Home

CDC Guidelines

Survive & Thrive Guide: Protecting Your Family

Meaningful Use is dead. Long live something better!

Impact of Social Distancing

Social Distancing

For COVID-19, this has

been estimated at 2.5 R0 is the average number

of people a sick person will infect

To Illustrate the potential of social distancing, the following assumptions are made:

There is a linear

correlation between social exposure and R

The median incubation period of COVID-19 is

approximately five days - after this period, a

person will experience symptoms and self

quarantine. o

5

Days

Source: The Math Behind Social Distancing https://www.visualcapitalist.com/the-math-behind-social-distancing/

Meaningful Use is dead. Long live something better! Social Distancing

DAY 1

1 Person

INFECTS

DAY 5

0.625 People INFECTED

DAY 30

2.5 People INFECTED

REDUCING SOCIAL EXPOSURE BY 75%

With these in mind, here’s how distancing measures can control the spread of the disease:



DAY 1

1 Person

INFECTS

DAY 5

1.25 People INFECTED

DAY 30

15 People INFECTED

Reducing Social

Exposure by 50%



DAY 1

1 Person

INFECTS

DAY 5

2.5 People INFECTED

NO SOCIAL DISTANCING MEASURES IN PLACE

406 People

INFECTED IN 30 DAYS

No Social Distancing At 30 Days

DAY 1

1 Person

INFECTS

DAY 5

2.5 People INFECTED


40

Stay-at-Home

DO NOT ENTER Social Distance

Separating Infected from Not Infected

Critical Concepts

CALL or TEXT __________

SELF

QUARANTINED

VIRUS FREE

ISOLATION

AREA

Coronavirus

COVID-19

DO NOT ENTER



Understand

the Basics

The Basics



Preparedness,

Protection, &

Performance

Improvement




Presence of Virus

On Surfaces Understand

the Basics

The Basics



Preparedness,

Protection, &

Performance

Improvement



Meaningful Use is dead. Long live something better! Infection Targets: Flu and Common Cold versus Coronavirus

43

Influenza

“Common Cold”

Upper Respiratory

Infection


Meaningful Use is dead. Long live something better! Infection Targets: Flu and Common Cold versus Coronavirus

44

Influenza

“Common Cold”

Upper Respiratory

Infection

Coronavirus

(SARS CoV-2)

Lower Respiratory

Infection


Meaningful Use is dead. Long live something better! Person-to-Person Transmission

45

Infectious Droplets &

Droplet Nuclei Travel Length

1-3 Feet 3-5 Feet 5-160+ Feet


Meaningful Use is dead. Long live something better! __________

The Centers for Disease Control and Prevention

recommends a 6-foot (2-m) separation. However, these

distances are based on estimates of range that have not

considered the possible presence of a high-momentum

cloud carrying the droplets long distances. Given the

turbulent puff cloud dynamic model, recommendations for

separations of 3 to 6 feet (1-2m) underestimate the

distance, timescale, and persistence over which the cloud

and its pathogenic payload travel, thus generating an

underappreciated potential exposure range for a health

care worker. For these and other reasons, wearing of

appropriate personal protection equipment is vitally

important for health care workers caring for patients who

may be infected, even if they are farther than 6 feet away

from a patient.


Meaningful Use is dead. Long live something better! __________

The Centers for Disease Control and Prevention

recommends a 6-foot (2-m) separation. However, these

distances are based on estimates of range that have not

considered the possible presence of a high-momentum

cloud carrying the droplets long distances. Given the

turbulent puff cloud dynamic model, recommendations for

separations of 3 to 6 feet (1-2m) underestimate the

distance, timescale, and persistence over which the cloud

and its pathogenic payload travel, thus generating an

underappreciated potential exposure range for a health

care worker. For these and other reasons, wearing of

appropriate personal protection equipment is vitally

important for health care workers caring for patients who

may be infected, even if they are farther than 6 feet away

from a patient.

Given the turbulent puff …

3 to 6 feet (1-2m) underestimate the

distance…

underappreciated potential exposure

range for a health care worker…



48




49


Loud Speech can emit

thousands of droplets per

second. They can remain in

stagnant air environment for

8-14 minutes.



50


Loud Speech can emit

thousands of droplets per

second. They can remain in

stagnant air environment for

8-14 minutes.



51


“substantial probability

normal speaking causes

airborne virus transmission

in confined environments”


52

Source: New Yorker Magazine May 13, 2020

Atul Gawande

Survive & Thrive Guide: Keeping Your Family Safe


53

Source: Nature Medicine 04-03-20



54

Source: Nature Medicine 04-03-20

Surgical Masks likely block 99% of Respiratory Droplets by

people with Coronaviruses or Influenza Viruses.



55

Source: https://fastlifehacks.com/n95-vs-ffp/


Surgical Mask Composition: Melt Blown Fibers


56

Source: Disaster Medicine and Public Health


Efficacy of Cloth Masks

“Surgical masks did three times

better than homemade masks at

blocking outward transmission of

respiratory viruses” Dr Gawande,

New Yorker Magazine


57

Source: https://www.preprints.org/manuscript/202004.0203/v1


Impact of Cloth Masks

A recent, extensive review of the research from an international consortium of scientists

suggests that if at least sixty per cent of the population wore masks that were just

sixty-per-cent effective in blocking viral transmission—which a well-fitting, two-layer

cotton mask is—the epidemic could be stopped. Dr. Gawande, New Yorker Magazine

https://www.preprints.org/manuscript/202004.0203/v1

https://www.preprints.org/manuscript/202004.0203/v1


58

Source: https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v2.full.pdf/


Benefit of Surgical & Cloth Masks to Wearer

Benefit to the wearer may be limited, but it’s likely not insignificant: laboratory research

has found that surgical masks reduce inhalation of respiratory-droplet-size

particles by about three-quarters. Two-layer cotton masks filter about half as

much on average, though a good fit can improve that considerably.

Dr. Gawande, New Yorker Magazine


59



The Takeaway: Masks Work

N 95 Mask Surgical Mask Cloth Mask


60



The Takeaway: Masks Work

“I protect you; you protect me”.

Dr. Gawande, New Yorker Magazine

N 95 Mask Surgical Mask Cloth Mask


SOURCE: CDC Website

Social

Distancing

Hand

Washing

Disinfecting

Surfaces

Care at

Home

CDC Guidelines



62

Source: https://pubmed.ncbi.nlm.nih.gov/11457626/ and Atul Gawande, New Yorker Magazine May 13, 2020


Handwashing Really Works

A 45% reduction in total outpatient visits for

respiratory illness was observed after

implementation of the handwashing program.

1,089,800 person-weeks were reviewed.

https://pubmed.ncbi.nlm.nih.gov/11457626/


63

Source: https://www.bmj.com/content/336/7635/77 and Atul Gawande, New Yorker Magazine May 13, 2020


Handwashing Really Works

Research on the 2002 SARS coronavirus

outbreak found hand washing more than

ten times per day reduced the infection

rate substantially.

https://www.bmj.com/content/336/7635/77


64

How Long Does Corona Virus Live on Surfaces?

*At 71 to 65 relative humidity

Adapted From Business Insider

Source: New England Journal of Medicine (NEJM) and The Lancet Microbe (L-M)

*At 69.8 to 73.4 degrees F (21 to 23 Degrees C) and 40% Humidity

Paper and Tissue

Paper**

Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days

Stainless Steel*

Polypropylene

Plastic*

Glass**

Paper Money**

Outside of

surgical mask **

2-3 days

3 days

4 days

4 days

7 days

Contact Surfaces


Contact Surfaces

Paper and Tissue

Paper**

Copper*

Cardboard*

Wood**

Cloth**

3 hours

4 hours

24 hours

2 days

2 days





How Long

Does Corona

Virus Live on

Surfaces?


Contact Surfaces





2-3 days

3 days

4 days

4 days

7 days

How Long

Does Corona

Virus Live on

Surfaces?

Stainless Steel*

Polypropylene

Plastic*

Glass**

Paper Money**

Outside of

surgical mask **



Coronavirus Test

Serum Antibody Test

AB



WHO do we test?

WHAT is tested?

WHY test?

HOW do tests work?

Testing: Who, What, Why, and How?

Infected Not Infected Infected and

Asymptomatic

Recovered and

Maybe Immune



TEST for COVID & AB

TRACE Contacts

TREAT Infected Early

ISOLATE the Infected

QUARANTINE those At Risk

TEST, TRACE, TREAT, ISOLATE, and QUARANTINE

Not Infected

Infected

Infected and

Asymptomatic


Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Seniors Unusual Symptoms

0 5 7 14 21 28 35

Presence

Of

Antibodies

COVID-19 RNA

and Antigen IgM Antibody

Days After Infection

IgG Antibody

No

Symptoms

Symptoms Recovery


Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Antibody Presence

0 5 7 14 21 28 35

Presence

Of

Antibodies

COVID-19 RNA



IgG Antibody

No

Symptoms

Symptoms Recovery

COVID-19 RNA

and Antigen


IgM Disappears


0 5 7 14 21 28 35

Presence

Of

Antibodies

COVID-19 RNA


IgM Antibody

Detectable


IgG Antibody

No

Symptoms

Symptoms Recovery

COVID-19 RNA

and Antigen


IgM Disappears


0 5 7 14 21 28 35

IgG Antibody

Remains in the

blood MAY provide

long-term immunity Presence

Of

Antibodies

COVID-19 RNA


IgM Antibody

Detectable


IgG Antibody

No

Symptoms

Symptoms Recovery

COVID-19 RNA

and Antigen


IgM Disappears


0 5 7 14 21 28 35

IgG Antibody

Remains in the

blood MAY provide

long-term immunity Presence

Of

Antibodies

COVID-19 RNA


IgM Antibody

Detectable


IgG Antibody

No

Symptoms

Symptoms Recovery

COVID-19 RNA

and Antigen

The Big Question:

How much

immunity do

these provide?

81

Emerging Threats






Heather Foster RN

Infection Prevention Nurse

ICU Nurse

Patient Safety Advocate

Cortez Colorado


82

Emerging Threats






William Adcox, MBA

Chief Security Officer

& Chief of Police MD Anderson

Cancer Center &

The University of Texas

Health Science Center

Coronavirus Survive & Thrive Guide:



Form Family Team &


Leadership A Miracle on

the Hudson

84

Emerging Threats








Critical Care








Form Family Team &


Leadership


• The Family CFO



HEAD

HEART

HANDS

VOICE

Engaging

Your

Family



Form Family Team &


Leadership


• The Family CFO




Response

Rescue

Recovery

Resilience

Readiness

Activate

Mobilize

Care Monitor

Family Health Security Plan



The Waves that Follow



TRUTH

TRUST

TEAMWORK

TRAINING Ann Rhoades

Jim Collins

Bob Chapman

Clayton Christensen




HEAD

HEART

HANDS

VOICE

What do you want

them to KNOW?

What do you want

them to FEEL?

What do you want

them to DO?

What do you want

them to SAY?

TRUTH

TRUST

TEAMWORK

TRAINING

The Science of

Spread and Safety.

The Fight for Life

for your loved ones.

Plan the Work &

Work the Plan

All Teach &

All Learn


91

Emerging Threats






Charles R Denham III

Co-founder Med Tac Bystander

Rescue Program

Junior Instructor


92

Emerging Threats






Heather Foster RN


ICU Nurse


Cortez Colorado


93

Emerging Threats






William Adcox, MBA



Cancer Center &






Care of Your

Loved Ones Practices

95

Emerging Threats








Critical Care






© 2006 HCC, Inc. CD000000-0000XX 96 © 2006 HCC, Inc. CD000000-0000XX Med Tac Bystander Rescue Care CareUniversity

Meaningful Use is dead. Long live something better! Survive & Thrive Guide: Editable Checklists



Checklists for Care at Home


SOURCE: CDC Website

Social

Distancing

Hand

Washing

Disinfecting

Surfaces

Care at

Home

CDC Guidelines




Care of Your

Loved Ones

Practices

• Why Checklists?


• Protecting the Home

Caregivers Giving Care


During Care at Home




Care of Your

Loved Ones

Practices

• Why Checklists?







Care of Your

Loved Ones

Practices

• Why Checklists?




Cleaning

Image


103

Emerging Threats






Heather Foster RN


ICU Nurse


Cortez Colorado


104

Emerging Threats






William Adcox, MBA



Cancer Center &






Putting Supplies

& Gear to Work

Technologies



Putting Supplies

& Gear to Work

Technologies

• Supplies & Gear

Checklist




Hand

Washing

Soap

Wash

Thoroughly

Await

Drying



Putting Supplies

& Gear to Work

Technologies

• Supplies & Gear

Checklist






Care of the At Risk & Seniors at Home Coronavirus Response



Care of the At Risk & Seniors at Home Coronavirus Response


Supplies Checklist:

Prescription Medications On Hand: Have at least 90 days of prescription medications on hand. If insurance will allow it, get a 120-day supply. If not, keep track of when they can renew them and then have them filled so they have them on hand.

Over the Counter Medications: Make sure they have over the counter medications for headache, colds, and other ailments they may have not needing prescriptions.

Thermometers: Every home should have a thermometer on hand to so that inhabitants can monitor their temperature whether healthy or sick. Many will get colds or the flu and may be frightened they may have Coronavirus.

Food and Bottled Water: It is important to have food on hand that will not spoil. If power goes out as it can in ordinary circumstances, it may take longer to repair if service personnel are sick. Food that does not require refrigeration or to be stored in freezers needs to be on-hand.

Flashlights and Batteries: (better than candles for reasons of risk) and batteries incase power goes out.

Cleaning and Disinfectant Supplies: Soap and water is very effective to kill the virus because it dissolves fats and the virus has a fat layer. Liquid Soap and water is even better than alcohol disinfectants for both hands and for contact surfaces for killing the Coronavirus. • If alcohol and soap runs out, bleach may be diluted to 1:10 Bleach to Water concentration for

contaminated clothing. • Dilution of 1:50 Bleach to Water concentration fordisinfecting contact surfaces. • Dilution of 1:100 Bleach to Water for skin cleaning. • Having plenty of liquid soap, buckets, and rags are important if caring for someone at home.

Paper towels may be in short supply – rags and towels cleaned in washing machines are safe. Kitchen Rubber Gloves: Two to three pairs of rubber gloves will be good to have on hand if one

has to take care of someone in the home. They should be used for disinfecting the surfaces. Some surfaces will sustain the virus for a few hours. Some, however, can sustain the virus for three to nine days. The virus lasts longer on-porous surfaces like door handles

Full Tank of Gas: If the supply chain is disrupted by illnesses of those transporting or operating gas stations, you may have a hard time getting fuel. We need to be as prepared as we would with a storm or during any natural disaster or emergency.

Reading Materials & Recordings: In the extreme case cable systems and internet providers may go down and seniors should have access to reading materials and recordings to inspire them and maintain hope. Our faith-based communities can provide tremendous support of them here.

Process Checklist: In Case of Emergency - ICE Contact List: Phone numbers and email addresses of friends and

family members who know they are going to be called if an individual experiences an emergency should be on an accessible list. The In Case of Emergency phone numbers should be generated. It should include those who have a Power of Attorney for healthcare and for business issues.

All Caregivers Contact Information: A master list of the doctors, nurse practitioners, pharmacists, and caregiver's office phone numbers, emergency numbers, and addresses should be on an easy to read list.

Local Support Individuals: Names and mobile numbers of friends and family who can pick up supplies for them, transport them, care for them, and check on them.

“If I Get Sick Plan”: A plan of “what if I get sick” directions. For instance – what signs and symptoms should prompt them to call for help. A certain temperature or other developments to drive action.

Hospital of Choice: If an individual has been under the care of a hospital, their medical records are very important to future care. They may identify that hospital or a hospital as a first choice for care.

Medical Power of Attorney: Everyone over the age of 18 will need to execute a medical power of attorney if they are to allow another person to make decisions regarding care if the victim is unable to do so. For instance, college students going to school in another state who are in another state get sick, parents will need one to get medical records.

Regular Expenses & Payment Mechanism: Create a list of regular bills and how to pay them if a person is in the hospital and unable to take care of them.

Regular Home Chores: A list of tasks that must be undertaken if residents become ill and are taken to the hospital should be created. They might include watering indoor and outdoor plants, pet care, and pet care.

Daily Check In Calls: Seniors and those with underlying conditions such as heart, lung, or kidney disease as well as those with immune compromised conditions such as chemotherapy and transplant patients should have someone check in on them if they are alone.

Food Replenishment Process: A process for regular replenishment of food and supplies should be set up.

Meals on Wheels & Support Programs: If seniors and those who qualify can be added to such programs, they should consider such support.

Sick Care Room: A room or section of the home should be identified where a family member can be treated in case, they become ill. This is whether they get the Coronavirus, a cold, or the flu.



Putting Supplies

& Gear to Work

Technologies

• Supplies & Gear

Checklist




Charlie &

Betsy

Milk

Carton



111

Source: C Denham

The 5 Rights of Emergency Care ®

Right Provider

Right Diagnosis

Right Treatment

Right Monitoring

Right Prevention Test

Treat

Diagnose Monitor

Watch

Rx

Right Diagnosis

Right Treatment

Right Discharge

Right Follow Up

H

MD

ED

Meds

F O

NEW

DC

PLAN

PHR

Home

Images

ICE

112

Emerging Threats






Christopher Peabody MD MPH

Assistant Clinical Professor

of Emergency Medicine,

University of California

San Francisco

Coronavirus Survive & Thrive Guide By Zoom Recording

113

Emerging Threats






Heather Foster RN


ICU Nurse


Cortez Colorado


114

Emerging Threats






William Adcox, MBA



Cancer Center &




115 © 2020 TMIT

National Survey Questions

I would like to attend the

CORONAVIRUS CARE & SAFETY Webinar Series

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative

to Neutral

4

The topics I wish to have covered in the

CORONAVIRUS CARE & SAFETY Webinar Series

115

117 © 2020 TMIT


I would like to invite individuals or groups to

CORONAVIRUS CARE and SAFETY Series

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative

to Neutral

4

The topics I wish to have covered in WEBINAR on

CORONAVIRUS CARE and SAFETY in this series

117

118 © 2020 TMIT


I believe there is value in

Locally Led Coronavirus Safety Programs

Very

Strongly

Agree

10

Strongly

Agree

9

Agree

8

Agree

7

Very

Strongly

Disagree

1

Disagree

3

Strongly

Disagree

2

Neutral

6

Neutral

5

Negative

to Neutral

4

I recommend the following individuals or groups

For the Opportunity be Informed About the Program

118

119

Emerging Threats





Speakers

& Reactors

Dr. Charles Denham

Chief William Adcox Dr. Gregory Botz

Becky Martins

Heather Foster RN

Dr. Christopher Peabody

120

Emerging Threats





Becky Martins

Founder, Voice4Patients.com

TMIT Patient Advocate Team

Member

Warren, ME

Voice of the Patient

121

Emerging Threats





RESOURCES



Flattening the Curve: Avoid the Surge

www.GlobalPatientSafetyForum.org Emerging Threats Community of Practice

http://www.globalpatientsafetyforum.org/

Readiness for Epidemics including preparedness for testing and

volume surges

125

Emerging Threats





Gregory H. Botz, MD, FCCM Professor, Department of Critical Care

Division of Anesthesiology and Critical Care


MD Anderson Cancer Center

Adjunct Clinical Associate Professor

Stanford University School of Medicine


A Critical Care Perspective


Meaningful Use is dead. Long live something better! Threat Safety Science: The Context of Emerging Threats

126

Emerging Threats

•Threat Velocity: The speed of new threats challenging us are appearing much faster

than ever before.

•Threat Spectrum: The range of different threats challenging us are increasing as well.

• Invisible and Visible Threats: Many of the threats are invisible to us until they are

upon us. The Coronavirus COVID-19 is an example of a threat that is invisible. Many

who are infected with the virus are asymptomatic AND contagious.

127

Emerging Threats





Chief William Adcox, MBA Chief Security Officer

MD Anderson Cancer Center

Chief of Police at University

of Texas at Houston


The Security Leader’s Perspective


Meaningful Use is dead. Long live something better! The Security Leader’s Perspective

Major Medical Centers – What you might expect to encounter:

1. Limited access points

2. Exterior access screening for everyone

3. Lines and delays

4. Limiting patient visitors and access to only patients and person

involved in direct patient care of the support of direct patient care.

5. No visitors under 18 years of age

6. Reducing and cancelling of elective surgery

7. Off-site screening and testing for COVID19

8. Public areas limited with social distancing recommended

9. Limited food services within the hospitals for visitors

10. Limited or eliminated valet services

11. Crowding and delays



Hospital Challenges for Security

1. PPE, Sanitizing and cleaning supplies are now in greater demand

and harder to obtain. The value of these has gone up and now

must be protected in ways not previous done.

2. Reduced access point while controlling access into the hospitals

3. Limiting visitors

4. Utilization of PPE

5. Patient surges

6. Reduced staffing

7. Fear

8. Added responsibilities



Police and Security – Changes occurring:

1. Non-violent crimes and misdemeanors not being accepted by jails and Juvenile centers

2. Diversion programs for habitual trespassers, alcohol intoxication, etc. closing

3. Some reporting of problems with Emergency Commitments due to illness

4. Setting up alternatives to first responders' homes for quarantine

5. Establish “drive up” testing and prioritized first responders and health care workers

6. Enhanced Sanitizing of police buildings, prisoner holding areas and vehicles

7. Staffs supplied with additional disinfecting wipes and hand sanitizer

8. PE deployments and testing (Nationwide shortages) 9. Communication Centers asking screening questions of

callers to better inform responding personnel and establish social distancing.

10. Limiting police responses to non-life threatening or crimes in progress calls

11. Taking more Reports over the phone instead of a police officer response.

12. Performing “Doorway Triage” at the scene of all 911 calls and asking complaints to come outside on calls.

13. Modified and reduced staffing plans 14. Civilian employees working from home where

possible 15. Repurposing of police officers assigned to special

assignments 16. Require social distancing inside police facilities to

include modified roll calls 17. Recommending officers sanitize their duty belts

and equipment, changing out uniforms at work or immediately upon reaching home to avoid contact with family



What we all can do:

1. Understand the virus and obtain information from credible sources only

2. Educate our children. Answer their questions. Understand their fear.

Establish new routines and expectations

3. Explain basic hygiene practices to our families and everyone’s responsibility

to practice good hygiene and help more frequently clean the most touched

surfaces

4. Support each other, their families and your community

5. Don’t try to over stock thus emptying out grocery stores


Meaningful Use is dead. Long live something better! Have you heard???

132


Meaningful Use is dead. Long live something better! Protecting You And Your Family

133

Objectives:

Background Information

Current Situation

Facts vs. Fiction

What can you do to stay safe?

How can you protect yourself and your families?

Coronavirus Survive & Thrive Guide for Caregiver ...€¦ · Survive & Thrive Guide: Keeping Your...

Documents

Transcript of Coronavirus Survive & Thrive Guide for Caregiver ...€¦ · Survive & Thrive Guide: Keeping Your...